Purpose: Vascular-related wounds are a significant burden on patients and the healthcare system, and the patient journey is often complicated by pain, delayed healing and high recurrence rates. Despite advances in vascular surgery and wound management, variation in clinical practice persists. This study aimed to explore current management of vascular-related wounds from specialist vascular nurses. A secondary aim was to identify barriers to evidence-based management and opportunities for service improvement. Methodology: A mixed methods study was undertaken using an online survey and semi-structured interviews. Specialist nurses working in Australian vascular units were recruited through the Australian and New Zealand Society of Vascular Nurses. Survey data were analysed descriptively, while interview transcripts underwent thematic analysis. Results: Twenty-one nurses completed the survey, and four participated in follow-up interviews. Findings revealed substantial variation in vascular wound management, including assessment, documentation, referral pathways and follow-up care. Participants identified workforce shortages, limited access to specialist resources, and competing clinical demands as barriers to care. Limited vascular education pathways and variability in expertise affected confidence in evidence-based management. Fragmented models of care led to poor continuity because of limited integration across services. Interview findings highlighted challenges in interdisciplinary communication and the absence of standardised protocols for complex vascular wounds. Conclusion: This study highlighted variability in vascular wound management practices within Australian healthcare services, largely driven by organisational and workforce constraints. Enhancing interdisciplinary education, collaboration and evidence-based protocols may improve continuity of care, support clinical decision making, and optimise patient outcomes.